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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Dysmorphic and anthropometric outcomes in 6-year-old prenatally cocaine-exposed children
Sonia Minnes1, Nathaniel H Robin, April A Alt
1Department of General Medical Sciences, Case Western Reserve University, 11400 Euclid Avenue, The Triangle, Suite 250, Cleveland, OH 44106, USA. sonia.minnes@case.edu
Insights
Prenatal cocaine exposure negatively impacts child growth, affecting height and weight. However, it does not cause a consistent pattern of birth defects, though other substances like alcohol and marijuana show specific abnormality links.
Area of Science:
- Pediatric Health
- Neurodevelopmental Disorders
- Prenatal Toxicology
Background:
- Prenatal exposure to substances like cocaine, alcohol, marijuana, and cigarettes is a significant public health concern.
- Understanding the specific effects of these exposures on child development and physical growth is crucial for early intervention and support.
Purpose of the Study:
- To assess the impact of prenatal cocaine exposure (PCE) on dysmorphologic and anthropometric outcomes in 6-year-old children.
- To compare outcomes between children with PCE and a high-risk control group (NCE).
- To investigate the dose-response relationship between prenatal substance exposure and specific physical and growth parameters.
Main Methods:
- Dysmorphologic and anthropometric assessments were conducted on 154 children with PCE and 131 NCE.
- Meconium analysis was used to quantify cocaine metabolite levels (BE).
- Statistical analyses controlled for covariates to determine the impact of various prenatal substance exposures (cocaine, alcohol, marijuana, cigarettes) on growth z scores and abnormality rates.
Main Results:
- Prenatal cocaine exposure showed a dose-response relationship with reduced height z scores and weight-for-height z scores.
- Higher average alcohol exposure predicted lower head circumference and weight z scores.
- Increased prenatal cigarette exposure correlated with higher rates of craniofacial abnormalities, while alcohol and marijuana exposure were linked to specific ear, chest, and head shape abnormalities.
Conclusions:
- Prenatal cocaine exposure adversely affects specific growth outcomes, including height and weight for height, but does not lead to a consistent pattern of structural abnormalities.
- The study highlights differential effects of various prenatal substance exposures on child growth and development, emphasizing the need for tailored interventions.
- Findings underscore the importance of considering the type and timing of substance exposure during pregnancy for predicting specific developmental outcomes.
Abstract:
Dysmorphologic and anthropometric assessments were performed on 154 6-year-old children prenatally exposed to cocaine (PCE) and 131 high-risk controls (NCE) of similar race and social class. Adjusted mean height z scores demonstrated a dose-response with metahydroxybenzoylecgonine above a threshold of 100 ng/g of meconium and greater cocaine exposure predicted lower weight for height z score. Higher average alcohol exposure throughout pregnancy and 3rd trimester predicted lower head circumference and weight z scores, respectively. Severity of marijuana use also predicted lower height for age but greater weight for height. There was not an increased rate of minor anomalies among the PCE cohort, nor was a consistent phenotype identified. After controlling for covariates, higher average prenatal cigarette exposure predicted higher incidence of cranial facial abnormalities. First trimester alcohol exposure predicted greater rates of ear abnormalities and third trimester marijuana exposure predicted greater rates of chest and head shape abnormalities. These finding indicate that prenatal cocaine exposure has a negative effect on specific growth outcomes including standardized height and weight for height, but not a systematic pattern of structural abnormalities.
